Some people only go to the doctor if they’re feeling ill or want to get something checked out. Others schedule an annual checkup to screen for the things that could possibly make them ill. I’m guilty of being one of the former.

In the Times’s Well blog, Doctor Danielle Ofri talks about how unsettling it is for her to read a new study concluding that “general health checkups for adults did not help patients live longer or healthier lives,” and then goes on to explain why annual checkups are necessary, which is basically: It’s better to find out you have a thing as early as possible, because the earlier you discover a thing, the earlier you can treat it. Here’s what she said she did for a 43-year-old man who came in to ask her about shoulder pain:

I checked his blood pressure to screen for the “silent killer” of hypertension. I noticed that he hadn’t had a tetanus booster in 10 years, not to mention an annual flu shot. I ordered a blood test for cholesterol. I went through his family medical history in case there were any particular diseases we should be on the lookout for.

We discussed a healthy diet and exercise. I screened for H.I.V., depression, domestic violence, smoking, and drug and alcohol abuse.

What I’d like to know from such a study is: If annual checkups don’t actually help patients live longer, what do they cost the health care system? And what if they’re more effective if they’re done every two years, instead of annually?

See, the healthcare system has solved this for approx. 30% of the population already. If you want to get a script for birth control, it’s used as a “carrot” to force you to have at least an annual pap and general wellness exam. It’s really annoying, honestly…even though I know it’s for my health, I resent that the scrip is used to force me to do something that obviously at least 50% of the population (the male half) doesn’t get similarly coerced into doing. Other than knowing I’m cancer-free (which is a big win, for sure) the general exams haven’t really done much other than allow my doctor her semi-annual opportunity to bitch about my weight.

@julebsorry Ew. I hope you get the opportunity to switch doctors, and soon. There exist doctors who will not do this!

The only down side of getting health insurance (which is AWESOME and I am SO NOT COMPLAINING ABOUT IT) is that I can’t really justify going to Planned Parenthood instead of a doctor that actually takes my insurance. PP never guilted me about anything, and I really miss that. I’ve found a doctor who’s pretty chill about my weight, at least, and doesn’t try to diagnose me with PCOS just because I’m overweight (but am lacking literally all of the other symptoms? WTF, previous doctor?), but she can still be kind of annoying about some other things.

I am also kind of annoyed that my (male) partner doesn’t get coerced into having some sort of sexual health screening every now and then. Or any kind of wellness exam. Ever. But maybe the solution is to just allow me to have my BC script over the counter and let everyone do as they will instead of coercing others into the same thing. I would probably get the pap anyway (given that I get STD tested every time if it’s covered by insurance even though I’m monogamous, so you can tell I’m kind of crazy about regular testing).

@julebsorry You might still be able to got to Planned Parenthood, sometimes if one isn’t covered another in a nearby area is. I used my parents insurance to go to PP all through college and now I’ve moved and the closest one isn’t covered I still get 70% covered as an out of network provider and there are in network PPs just a little farther away. If you really prefer going to PP (I definitely do, it’s the only place where the doctors aren’t mean to me) it might be worth it to look around a little and see if there is still a way you can go.

@julebsorry This is actually one of the reasons why my husband and I use condoms even though we’ve been together 12 years. I probably go to the ObGyn once every other year? I feel like that’s plenty–I’m generally healthy and have had bunches of negative STI tests since becoming monogamous.

@seaermine Good advice – and something I actually did look into when I got insurance. I can’t, because I’m on a very limited HMO and can’t go outside my county or really outside of a very small list of providers. BUT there are tradeoffs… the things I do medically are all very cheap or free now if I just go to doctors on the list, so I’ll take it.

…that said, now that I have more money, every time I get an annual exam somewhere else I donate a copy of my copay to PP.

@julebsorry The thing that annoys me about this is that the CDC and the american college of obstetrics and gynecology only recommend a pap test every 3 years, especially if you have never had anything come up on one. I imagine if they would just have you come in for a regular physical it would be a lot faster, less expensive, and less invasive and people wouldn’t mind it so much so they would probably be in better compliance. The docs wouldn’t waste time on an unnecessary test but can still bill for an office visit, and patients can get their BC scripts and be on their merry way.

@ThatJenn Exactly! My partner doesn’t get pestered and harassed yearly about his sexual health, but for some reason women are supposed to just accept the “this is for your own good” line when the doc can hold back something we want. It’s pretty infantalizing (and yes, I think BC should be available OTC although I know not everyone agrees with me on this).

But, it definitely answers the question “do you get yearly checkups” for most 20 and 30-something women. Yup, we do, and it kinda sucks (and why I’m very thankful for Obamacare, which doesn’t lessen the annoyance of the visit but at least frees women from the burden of additional costs for exams that men aren’t typically subject to).

@julebsorry Planned Parenthood isn’t doing annuals anymore according to the new recommendations that came out last year. For my “well-visit” this year, they just asked me some questions and since nothing came up they rubber stamped me and gave me my b.c.

I get a “wellness bonus” from my insurance at work for, among other things, having an annual checkup (or, alternatively, a work-sponsored blood test where I think they check your glucose, cholesterol, and blood pressure).

I agree with julesorry. I know when I am well and I know when I need care. Sorry, I just do! But I take 2 perscriptions, one for arthritis and the other a beta-blocker (long story) and I resent that my doctor keeps me on a short leash, demanding that I waste my time and my company’d health ins. dollars with pointless yearly “check-ups.”

Also, I am older than you guys and when I was coming up we didn’t do all this try-to-catch-it-early nonesense. And we liked it that way! So far I have refused a colonoscopy, never had a mammo, and any other procedures and tests my doctor offers me I politely decline.

Just because this one doctor is horrified at the study and was able to find some things she wanted to treat on her patient– that does not convince me. Lots of treatments come with unintended consequences. And men are notoriously worse at taking care of themselves (I qam a woman).

@Trilby I don’t want this to sound combative (I’m Canadian! So I apologize up front!) but it’s actually hard to know “when you are well.” Most chronic or serious illnesses are hard for you to detect- serious ones like pre-cancerous changes to your cervix, high blood pressure, high cholesterol, STIs.

I agree overscreening is a serious problem and that people are generally encouraged to be terrified of illness and to believe that more screening is better. But a lot of simple, basic tests can really help catch things that you won’t notice until they have a big irreversible impact.

I believe in going for periodic checkups, although do not make it in for a physical every year (maybe every few years.)

But I am I pretty motivated since my mom has survived 5 different cancers due to early detection. One was spotted during a yearly eye exam, one during a yearly mammogram (she ended up having two different types of breast tumors), one in follow up appointment, and the latest through noticing something and followed up with a doctor.

I probably have some different risk factors than most people with my family history, but I try not to think of excuses to ignore things about my body or go to the doctor.

My insurance pays for annual exams, and my doctor’s office sends me reminders to schedule appointments. It’s in my best interest to get that exam, not anyone else’s, plus if it’ll cost me nothing and just take an hour and a half of my morning, I’ll do it.

Ditto with how men don’t have a carrot to get regularly screened- UGH.

@kira fisher@twitter I think the question is though, from the argument of this study and others, is it really in your best interest and no one elses to do it every year? It’s not clear that so much testing is doing much for our health and it’s inflating healthcare costs so that when you really do need care, it’s going to cost a lot more. And there is money to be made of these tests too, its not as if they are a non-profit service. The hospital you go to may be non-profit, but the companies that make the tests and read them are usually for-profit. So really someone else may be benefitting from that, and you may not be. I work in healthcare and my husband is a physician, so it’s not as if I don’t believe screening for cancer can save lives, but I also see the business end of things too – there is a huge money making industry right now for drug and lab companies.

I actually just made an appointment for my check-up. I skipped 2012 accidentally, but it’s a free, usually short, session where you may just catch something early, so why not? My father caught his cancer early with a routine colonoscopy, but at my age I’m just more interested in knowing who my doctor is and having a history with her before I have to go in dying to get a prescription for antibiotics or pain meds, or whatever ailment I randomly catch this year.

Health insurance analyst here, I focus on researching utilization of health care. I believe there are more Pop Health people here who should ring in shortly.

Trying to summarize a whole lot of thought in a limited amount of time. In any insured group a minority of the group will be the majority of your costs : 20% are 80% of costs 10% are 90% of costs something like that. Healthy people seeing their Family practitioners are not “the problem”. Surgeries, cancer, stays in rehab or nursing homes etc., that’s where the real costs are.

That said, a yearly visit will not save your life, until it does. You have to catch the right person at the right time. For years I had my annual visits with much to do about nothing, until the year they found I was a hair away from cervical cancer. They removed my cervix and some of my uterus which definitely saved me from having to go through chemotherapy/radiation if not my life.

For type II diabetes patients, they should see the doctor but they have to do the work (manage their diet, do the testing, take their meds) in order for the impact on their health to be seen. Doctors can only observe. In high risk pregnancies health care can’t undo the fact that many of those women tend to be young, are poor, they smoke/d, and may have unstable living situations. Some conditions have no treatment, just symptom management. Some conditions have treatments, but they don’t always work.

So the recommendation on how often people should see the doctor should be staggered. Less for healthy, young people, put BC over the counter, and more often for certain conditions etc. But saying they have no value is way too broad of a statement.

I used to go quite regularly, but now I don’t really like my GP so I don’t like going (Canada). But I definitely agree that you should go once a year. My Dad might have actually survived his esophageal cancer if he hadn’t waited until he couldn’t eat anymore to see a doctor (he hated doctors and hospitals, and I would be lying if I said I wasn’t sometimes mad at him for not doing such a simple thing, because maybe he would still be here.)

Wow – I truly never knew there were people who disliked going to the doctor for a checkup. Out of curiosity, why? Is it THAT much of a hassle to go once a year? To me, it’s just one of those things humans do, like having your teeth cleaned, that you *can* live without and be “tough” about but is one of the many reasons it’s better to live now than in the Middle Ages.

I’ve had a lot of health problems this year so I’ve been to the doctor like once a month, so I admittedly am hugely biased, but the idea of not wanting to go as infrequently as once a year is crazy to me. Isn’t it nice at least to get told that you’re in great health? And if you’re not, isn’t it valuable to get that feedback so you can be proactive about it? Seriously, I’m really not a hypochondriac, but I cannot think of a single year in which I did not have at least one question I was glad to have the opportunity to ask my doctor.

@Ellie Yeah, if you have a doctor who shames you for your lifestyle choices, or your weight, or your past medical history – it can be really difficult to get yourself motivated to spend the time and money to go. It sounds like you’ve been lucky to have doctors who give you relevant advice, but if the “valuable feedback” you get every time you go is “your birth control choices are immoral” or “you need to lose weight” or “I don’t want to prescribe you medicine, try this herbal supplement,” that’s not really that valuable.

@polka dots vs stripes yeah I’m with you. I basically won’t go to my dr because she weight-shames me and asks me invasive questions about my sex life and lauds me for using condoms in a patronizing way.

As a 31-year-old who just spent the past year dealing with breast cancer, chemo, radiation and all that jazz, I can only say: *do your check-ups*. I have always been super healthy, exercized regularly, rarely ever get even a cold or flu, and this still happened. I didn’t even have a family doctor before cancer. A good friend of mine from my support group for young adults (people in their 20s and 30s) with cancer found out about her ovarian cancer through a pap when she was *22*. Everyone in the support group felt themselves to be really healthy. But sometimes through check-ups and sometimes through other casual visits to the doctor, we discovered these malign cells and tumours that have been growing inside us, sometimes on organs that we never even thought about (adrenal cancer anyone).

I am, however, in Canada though, so not sure how the insurance part plays out in the US. Still, if you’re insured, it’s worth the peace of mind SO MUCH. Even for breast cancer, early detection can mean the difference of the size of my scar from surgery could have been smaller, or I could have been spared chemo.

This is relevant to my life! After being a student and moving around and not seeing any kind of doctor regularly (except dentists and the eye doc and the gyno), I am finally getting all kinds of checkups with new doctors and paying out the nose for it, despite having insurance!

Regular checkups are a pain and can be expensive (copays whoo), especially when you’re trying to find new doctors but it’s worth it to me for
1) the patient history
2) catching things early

My family has a long history with skin cancer, and I went to a dermo yesterday just to have someone who has seen my skin without problems and in the future will be able to look at something and say – that’s different, and it’s weird. Like someone said above – you don’t catch anything early until you do. If my parents skipped their dermo appointments, who knows what would have happened, and if my mom skipped her gyno checkups, they would have caught her cancer much later (and a a much more dangerous stage) than they did. I have heard enough “caught it early” breast cancer stories that I’ll start getting mammograms as soon as I’m eligible.

I’m convinced annual checkups save lives, although I am open to the idea that they should maybe be every 2-3 years instead of 1-2.

I haven’t had a regular physical in more than 5 years- before I was going to college. I stopped working at sleepaway camp, so I didn’t have a medical form that needed to be filled out every April or May. I saw an NP at the campus health center every year for my BC prescription, and went to Planned Parenthood during my stretch of underemployment. I saw an actual OB/GYN for the first time this past year! But still no general practitioner. I should probably do that- family risk of absolutely everything means that I should probably get some blood work done, get my numbers checked, etc. But I keep not doing it, with no real excuse because I’m insured.

I feel like Canadians and Americans must have such different views on this- since it doesn’t cost me anything to get a regular checkup or the usual 20-something lady screenings (STIs, breast, cervix, etc etc) I don’t see any downsides. I see a doctor every year for my birth control prescription refill and that’s a chance to check in about any health issues.

As someone who works in prevention, can I just say: prevention is good.

I have not a had a checkup in almost a decade, but I put it on my list of new year’s resolutions for this year, and then this post prompted me to pick up the phone and make the appointment. I am counting this as my one thing for the week.

I live in Canada so cost is not a deterrent, but being lazy about making appointments, plus being nervous that the doctor will be a dick and/or that something is terribly wrong with me have caused me to put it off. I grew up getting a checkup every year and I’m at risk for a lot of stuff because of my family medical history which means I should just do it, but I’ve still managed to put it off until now. It has been very easy to just tell myself that getting sick is something that happens to other people.

Man it sucks that so many people have had bad doc experiences. If they were bad enough, I hope that you report them. I recall some earlier post thread about reporting a horrific inappropriate doctor but can’t remember where it was now.